Postpartum Health
❶ Changes in the Mother's Body After Birth
Your body typically takes about 6 to 8 weeks to return to its pre-pregnancy state following childbirth. This timeframe is known as the postpartum period, during which various changes occur in the mother's body.
●Uterine Recovery and Afterpains
Immediately after childbirth, the uterus weighs around 1 kg but reduces by about half to 500 g one week post-birth, eventually returning to its pre-pregnancy weight of 60 to 70 g within 6 to 8 weeks. The rapid shrinking of the uterus may cause stomach pains for approximately three days post-birth, referred to as postpartum pain, but this is normal and not a cause for concern.
●Vaginal bleeding or discharge (Lochia)
Following childbirth, you may experience a discharge that contains blood from the uterus or vaginal wound, known as lochia. Initially, lochia appears blood-colored for the first 2 to 3 days but changes to brown as the uterus heals, and then to yellow after about 6 weeks.
●Return of Menstruation
The timing of menstruation's return varies among individuals, influenced by the mother's recovery and whether she is breastfeeding. For some, menstruation may resume as early as 3 months postpartum, but it can be delayed for those who are breastfeeding.
Uterine Recovery
Immediately after childbirth, the uterus will rise to a level about two to three fingers' width below the navel, then to the level of the navel the following day, before gradually decreasing in size over the ensuing days.
❷ Postpartum Health Management
The postpartum period is a time for you to recover physically while also taking on new responsibilities, such as child care. It is crucial to collaborate with your family to ensure you get enough rest and maintain mental stability.
Getting out of bed and Household Tasks
The timing of hospital discharge can vary by facility but typically occurs between 4 to 7 days after childbirth. Once you're home, gradually resume your daily routines as your body allows.
Historically, the practice was to spend most of the time resting in bed after childbirth, packing away the bedding only after three weeks. However, the current consensus is that it's beneficial to get out of bed and return to normal life as soon as possible to aid in recovery, provided there are no complications. Nevertheless, it's important not to overexert yourself. Taking breaks by sitting on a chair or sofa can be beneficial.
●Household Chores
You may start engaging in light household tasks soon after discharge from the hospital, as long as these activities do not cause strain. Avoid standing for prolonged periods and increase your activity level gradually.
●Bathing
It's recommended to take showers or to only pour hot water on yourself until 4 weeks postpartum. Following your postnatal checkup, if there are no complications, you may take regular baths, but ensure the water is clean to prevent uterine infections and mastitis.
Symptoms to watch out for after childbirth
- Persistent abdominal pain
- Excessive red, bloody discharge
- Frequent urination, Pain during urination
- Continuous fever of 38 degrees Celsius or higher
- Breast pain accompanied by a warm lump
If you experience any of these symptoms, it is crucial to contact your obstetrician or gynecologist immediately.
Focusing on Your Mental Health Postpartum
After childbirth, a mother undergoes significant physical and hormonal changes, which can also impact her mental state. Additionally, adjusting to life centered around the care of your baby might lead to unnoticed feelings of anxiety and mental fatigue. It's important to be mindful of not only your physical but also your mental well-being after giving birth.
Remember, you're not alone!
Regarding postnatal child care, it's wise to have discussions and make plans with your partner and family members well before the baby arrives. Aiming for your partner to take a significant amount of parental leave can help distribute the caregiving responsibilities more evenly. Additionally, many hospitals and maternity clinics offer postnatal support services, including check-ups two weeks and one month after birth. Investigating the services provided by local hospitals, maternity clinics, health centers, and children and family centers beforehand is recommended.
Maternity Blues
The brief period of emotional fluctuations experienced in the initial days following childbirth is known as "maternity blues." This condition is temporary and tends to subside as you adjust to your new routine. It’s important for your support network to be aware of this and for you to not overly stress about these feelings.
Postpartum Depression
Unlike maternity blues, postpartum depression involves long-term, intense feelings of depression and is considered a serious mental health condition. If symptoms such as persistent anxiety, nervousness, insomnia, or depression persist, it’s critical to seek assistance from hospitals, maternity clinics, health centers, or child and family centers promptly. Early intervention can lead to a quicker recovery.
●Vulvar Hygiene
During the period of lochia, there's a heightened risk of inflammation from bacterial infections, making it essential to maintain vulvar cleanliness.
For about a week after hospital discharge, ensure your vulva is kept clean by gently wiping with sterile cotton after urination or bowel movements. When using a flushing toilet, take care to avoid water splashing from back to front, and use a bidet if available, directing the water flow from front to back.
How to Disinfect the Vulvar area
Clean the central area first (①), followed by the sides (② and ③), moving towards the anus.
Use a new disinfectant wipe for each clean.
●Sexual Activity
You can consider resuming sexual activity once you have had your one-month postpartum checkup, if your baby is well, there's no pain in the perineum, and you feel mentally ready for intimacy.
Post-pregnancy hormonal changes, concerns about scars, and new stresses such as breastfeeding and baby care can increase the likelihood of discomfort due to vaginal dryness during sex. Open communication with your partner is encouraged, and using Lube Jelly (lubricating jelly) can help.
*Lube Jelly - developed in 1982 by the Japan Family Planning Association Medical Committee, was the first lubricant in Japan designed to ease discomfort during sex. Being water-soluble, it's also condom compatible.
❸ Postpartum Exercises
The abdominal wall and birth canal may become lax due to pregnancy and childbirth. Engaging in appropriate exercises can help in regaining their pre-pregnancy state.
Postpartum exercises aim to remedy the laxity in the abdomen and pelvic muscles. They also support physical and emotional recuperation. It's advisable to seek guidance from your doctor or midwife and tailor the exercises to your physical capabilities.
On the day of childbirth
Leg exercises (about 10 times each)
While lying on your back with feet together, extend or flex your toes.
Rotate the soles of your feet towards each other, keeping your toes pointed.
1 day postpartum
Raise and lower hands (about 10 times)
①
②Extend your arms out and press your palms together above you.
Raise your head (about 5 times each with right and left hands)
With one hand on your abdomen, lift your head to view your hand.
Inhale and gently lower your head back down.
2-3 days postpartum
Abdominal muscle exercise (about 5 times)
With hands placed under your lower back, tense your abdominal muscles and lift your head only. Inhale and relax.
4-5 days postpartum
Pelvic exercise (about 5 times on each side)
Lie on your back, extend your arms by your sides, and bend your knees. Gently tilt your knees to one side, keeping them together.
Take a breath and turn to the other side.
①
②
6-7 days postpartum
Raise your legs (about 5 times on each side)
Lying on your back with knees bent, lift one leg at a time, bending at the knee and then extending.
①
②
③
Exercises focusing on tightening the anal area are beneficial for preventing urinary incontinence.
Postpartum Life Calendar
| Guide to Life | |
|---|---|
| 0 weeks postpartum (0-6 days) |
・Begin walking 7 to 8 hours after childbirth (for cesarean deliveries, commence walking the following day) ・Breastfeeding practice ・Prioritize rest throughout the week. ・Seek advice on post-discharge living during your hospital stay. |
| 1 week (7-13 days) |
・Emphasize relaxation and baby care over other tasks. ・Avoid strenuous housework to prevent strain. ・Keep your body clean with showers or pouring hot water on yourself ・Continue postpartum exercises Prevent constipation with cold milk, cold water, fruits and vegetables 
Establish a regular bathroom routine. |
| 2 weeks (14-20 days) |
・Gradually reintroduce housework, ensuring not to overexert yourself. ・Attempt getting out of bed and engaging in your usual daily activities if feeling up to it. However, if you feel tired, take a break immediately. |
| 3 weeks (21st to 27th) |
・Slowly increase housework, mindful of your physical well-being. ・Refrain from lifting heavy items to avoid injury. ・Engage in light outdoor activities like shopping or walking. 
Focus on both physical and mental rest. |
| 4 weeks (28th to 34th) |
・Aim to manage most home and childcare duties independently. ・You may take a regular baths. Depending on your comfort level, you can start after your one-month checkup. ・Attend a one-month postpartum checkup. If the checkup shows no complications. you may go out for a longer trips. ・You may resume sexual activity following medical advice. 
Moderate exercise |
Discuss and allocate housework and childcare responsibilities among family members.